Findings from 19 systematic reviews indicate that using surgical mesh significantly lowers the risk of both clinically and radiologically detected parastomal hernias. The pooled hazards ratio for clinically detected hernias was 0.33, while it was 0.55 for radiologically detected hernias. Additionally, mesh use was associated with a reduced need for surgical repair (hazards ratio 0.46), […]
Category: General Surgery
Total mesopancreas excision enhances surgical outcomes in pancreatoduodenectomy.
In a systematic review of 738 pancreatic head cancer patients, total mesopancreas excision (TMPE) significantly increased R0 resection rates (RR 1.24) and reduced overall (RR 0.53) and local recurrence rates (RR 0.39) compared to standard pancreatoduodenectomy. TMPE also reduced blood loss (MD -143.70 ml) and enhanced lymph node harvest (MD 7.27 nodes), all while showing […]
Multimodal nomogram enhances assessment of gastric cancer invasion depth
A combined nomogram integrating IVIM-DWI parameters and MRI characteristics achieved AUC values of 0.901 and 0.883 in training and validation cohorts, respectively. This approach effectively distinguishes between T1-2 and T3-4 stages of gastric cancer, addressing the challenge faced by radiologists in preoperative assessments. No significant difference was found between individual models, indicating the multimodal approach’s […]
Adjuvant therapy improves recurrence-free survival in HCC patients
Camrelizumab plus apatinib in a real-world setting has shown significant benefits in recurrence-free survival (RFS) for patients with hepatocellular carcinoma (HCC) with microvascular invasion following radical resection. The comparison between adjuvant therapy (99 patients) and observation (172 patients) indicated a hazard ratio of 0.52 for RFS improvement (p
3D virtual modelling enhances safety in laparoscopic colon surgery
Validation of 3D virtual modelling (3DVM) demonstrated a 96% accuracy for identifying arteriovenous variations in laparoscopic complete mesocolic excision with central vascular ligation (CMECVL) among 26 patients. Compared to 49 standard mesocolic excision controls, CMECVL showed no intraoperative complications and similar 30-day morbidity rates, although intraoperative times were longer initially. Aimed at improving surgical safety, […]
Sugarbaker technique shows lower recurrence in parastomal hernia repair
Findings from a retrospective analysis of 81 patients reveal a 25.9% recurrence rate and a 16.0% complication rate for large parastomal hernia repairs using lap-re-do techniques. Notably, the lap-re-do Sugarbaker technique demonstrated a significantly lower recurrence rate of 12.2% compared to 40% for the Keyhole technique. Complication and reoperation rates were also more favorable with […]
Robotic-assisted NOSE offers superior outcomes in colorectal surgery
This meta-analysis compared robotic-assisted natural orifice specimen extraction (NOSE) with traditional robotic transabdominal wall specimen retrieval (TWSR) in colorectal cancer surgeries involving 717 patients. Findings revealed that the NOSE technique resulted in significantly lower overall postoperative complications (OR 0.55; p=0.01) and indicated its safety and effectiveness as an alternative to TWSR. Enhanced recovery metrics were […]
Computer vision algorithm outperforms experts in predicting SMA margin status.
A computer vision algorithm was developed to predict superior mesenteric artery (SMA) margin status in pancreatic ductal adenocarcinoma patients using preoperative CT scans. In a study involving 200 patients, the algorithm achieved a sensitivity of 0.43, outperforming radiologists (0.23) and surgeons (0.36). Specificity was high across the board, with both the algorithm and a radiologist […]
Preoperative hypoalbuminemia increases mortality and complications post-esophagectomy.
Preoperative hypoalbuminemia is linked to higher 30-day mortality and complications after esophagectomy. In a study involving 803 patients with hypoalbuminemia compared to 7046 controls, matched analyses revealed mortality rates of 4.48% for those with low albumin versus 3.00% for those without. Findings suggest that recognizing and addressing preoperative hypoalbuminemia may be a cost-effective risk stratification […]
CT-based radiomics model effectively predicts fibrosis in PDAC patients
The study established tumor fibrosis as an independent prognostic factor for survival in pancreatic ductal adenocarcinoma (PDAC) patients, identifying a 40% collagen fraction cut-off value crucial for prognosis differentiation. Utilizing a CT-based radiomics model, researchers achieved areas under the curve of 0.825 and 0.745 in training and test cohorts, respectively, outperforming traditional models in predicting […]